L&I Medical Attending
Dr. Niles M Roberts, MD
L&I Attending Physician
As your L&I attending physician, it is my job to understand the injuries that are the basis of your claim, and come up with a plan to get you well and working again, while ensuring your time-loss payments (if you’re entitled) keep coming in the meantime.
I do not manage emergent or urgent injuries, but I do know that some problems appear time-critical only to a trained mind, and know when to send a patient to a specialist urgently or even to the ER.
If a care plan (either mine or a surgeon’s) doesn’t result in an expected recovery, I find out why and get a new plan.
History & Physical Assessment
Regardless of how old your injury is, on my initial visit, I will take a complete history with physical exam. I have encountered instances where an injured worker has been initially assessed by an employer’s contract doctor/nurse, or a busy PAC or ARNP, or even a chiropractor, and then I discover injuries that were misdiagnosed or overlooked. I am on the lookout for this situation with every new patient. If I suspect an overlooked or misdiagnosed injury, I will order studies (e.g. an MRI) to obtain data to substantiate my suspicion, and should it be confirmed, I will take action to get it allowed on your claim. Once allowed, I will either treat it directly or refer you to an appropriate specialist.
Physician / Physiatrist
Because I am a Physical Medicine & Rehabilitation (PM&R) physician, AKA Physiatrist, I generally see patients well after the date of injury, typically when they have completed their surgical or medical care, but still have yet to complete final recovery, or have loss of function, or restrictions or limitations that preclude return to the job-of-injury.
Dr. Niles M Roberts, MD
A Typical Plan
In this situation, I monitor the the injury, and assess whether the prognosis will ultimately allow for return to the job or occupation you had when you were injured. A typical plan for this situation may involve physical therapy, perhaps work conditioning, work hardening, or activity-modification. Where appropriate, I may recommend ergonomic equipment with accommodation on the part of the employer. I may order supportive services such as psychological counseling to help injured workers cope and adjust to the process of rehabilitation or long-term loss of bodily function.
In situations were a return to the job or occupation of injury is not feasible, and once your medical condition is fixed and stable, I may order a functional capacity evaluation to ascertain what your physical capabilities are, and with that information, I work with L&I vocational counselors who will in turn work with you to come up with a vocational retraining plan. During this period of transition, I will not only monitor your condition, but will also complete L&I paperwork to ensure that your claim remains open and that you continue to receive time-loss income from L&I.
Opioids
Some injuries result in chronic pain, and I offer pharmacologic pain management (mostly without opioids), or I may refer you to an interventional pain specialist, who typically guides a needle under live x-ray to inject analgesics or steroids to a pain-generating structure. I generally don’t prescribe opioids, and don’t prescribe long acting opioids unless and until other plans have failed. I do not introduce opioids for old injuries, unless the injury has demonstrably worsened, and there is a treatment plan for the underlying cause. I judge on a case-by-case basis as to whether to continue an opioid regimen initiated by a previous physician.
How to get started
1
Request Appointment
Office hours: MON - THUR ~ 10am to 4pm.
Call us to get you in!
2
Before Your Visit
Print & fill out these forms:
1) Intake Form - PDF
2) PatientMHx - PDF